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Pneumococcal vaccination among adults 65–70 years of age before and during the COVID-19 pandemic

Table 1. Report of any prior pneumococcal vaccination (≥1 dose) by age and birth year 

1948-1956, NHIS 2015-2021*

By age 65+ By age 66 By age 67 By age 68 By age 69 By age 70 

Combined age 65-

70 in 2018, 2019 

(pre-pandemic), 

2020, and 2021 

(during pandemic)‡

Birth year N

1948 2,011 53.6 (48.2, 58.8) 65.1 (59.8, 70.0) 71.1 (64.6, 76.8) 70.3 (65.0, 75.0) 61.2 (58.9, 63.4)

1949 2,567 51.5 (45.2, 57.8) 59.6 (53.9, 65.1) 64.0 (58.5, 69.1) 65.8 (60.4, 70.8) 69.3 (63.8, 74.2) 59.7 (57.5, 61.8)

1950 3,168 48.6 (43.2, 54.0) 60.9 (55.5, 66.1) 62.0 (56.7, 66.9) 66.8 (61.5, 71.7) 66.1 (61.5, 70.5) 69.5 (64.3, 74.4) 60.1 (57.9, 62.3)

1951 3,087 44.7 (39.7, 49.8) 57.4 (51.7, 63.0) 63.1 (57.9, 68.0) 65.8 (61.1, 70.2) 64.8 (59.8, 69.4) 64.2 (59.0, 69.1) 58.5 (56.4, 60.5)

1952 2,515 49.2 (44.0, 54.4) 58.0 (52.4, 63.3) 61.3 (56.3, 66.1) 66.0 (60.9, 70.7) 66.9 (61.9, 71.6)

1953 2,152 45.4 (40.2, 50.8) 56.2 (51.4, 60.8) 59.4 (54.4, 64.3) 59.7 (54.9, 64.4)

1954 1,719 42.9 (38.4, 47.4) 57.3 (52.5, 61.9) 61.0 (55.7, 66.0)

1955 1,107 44.9 (39.8, 50.1) 55.3 (50.7, 59.8)

1956 508 44.4 (39.4, 49.6)

Combined 2020-

2021 (during 

pandemic) by 

age§

6496 44.7 (41.1, 48.3) 56.3 (53.0, 59.5) 60.2 (56.6, 63.7) 62.8 (59.3, 66.1) 65.8 (62.4, 69.2) 66.9 (63.3, 70.4) 59.3 (57.8, 60.8)

*Table cells are shaded according to whether persons with the indicated birth year (rows) reached the age indicated (columns) in 2015–2017 and 

2019 or 2018 (pre-pandemic, shaded in orange or yellow) or in 2020 or 2021 (during pandemic, shaded in blue). Cells shaded in yellow were used as 

the pre-pandemic referent cell (those reaching the age in 2018) for comparisons with pandemic cells, for each age indicated (column).

+ Age based on year of birth and survey year. For example, data for persons born in 1950 who reached age 65 were obtained from the 2015 NHIS, 

and some could have still been age 64 when interviews were conducted.

‡ Combined age 65–70 in 2018 or 2019 (pre-pandemic, shaded in yellow or orange; n=2,718 for 2018 and n=3,365 for 2019) and 2020 or 2021 

(during pandemic, shaded in blue; n=3,509 for 2020 and n=2,987 for 2021).

§ Combined 2020–2021 (during pandemic) by age, persons with the indicated birth year (rows) reached the age indicated (columns) in 2020–2021 

(combined two blue cell shadings) (e.g., for coverage by age 65 years, people born in 1955 or 1956 reached 65 in 2020 or 2021, which was during 

pandemic).
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Table 2. Difference in vaccine coverage of pneumococcal vaccination (≥1 dose) by age and birth year 1948–

1956, National Health Interview Survey 2015–2021*

By age 65+ By age 66 By age 67 By age 68 By age 69 By age 70 

Combined 

age 65-70 in 

2018 (prepandemic), 

2020, and 

2021 (during 

pandemic)

Birth year N

1948 2011 ref ref

1949 2567 ref

1950 3168 ref -0.8 (-7.9, 6.3) -1.1 (-4.2, 2.0)

1951 3087 ref -1.0 (-8.1, 6.1) -6.1 (-13.2, 1.0) -2.7 (-5.7, 0.3)

1952 2515 ref --0.8 (-7.9, 6.3) 1.1 (-6.0, 8.2)

1953 2152 ref -3.7 (-10.8, 3.4)

-7.1 (-14.1, -

0.1)§

1954 1719 -0.7 (-7.9, 6.5) -2.1 (-9.3, 5.1)

1955 1107 -0.5 (-7.9, 6.9) -2.7 (-9.8, 4.4)

1956 508 -1.0 (-8.4, 6.4)

Combined 

2020–2021 

(during 

pandemic)‡

compared with 

2019 (prepandemic)

1.8 (-4.0, 7.6) 0.1 (-5.6, 5.8) -1.1 (-7.2, 5.0) -3.0 (-8.7, 2.7) -0.3 (-5.9, 5.3) -2.4 (-8.7, 3.9) -0.4 (-3.0, 2.2)

Combined 2020-

2021 (during 

pandemic)‡

compared with 

2018 (prepandemic year) 

-0.7 (-7.1, 5.7) -1.7 (-8.0, 4.6) -2.9 (-9.1, 3.3) -4.0 (-10.1, 2.1) 0.0 (-6.2, 6.2) -3.4 (-9.5, 2.7) -1.9 (-4.6, 0.8)

Combined 2020-

2021 (during 

pandemic)‡

compared with 

2017 (prepandemic year)

-4.5 (-10.8, 

1.8) -1.1 (-7.6, 5.4) -1.8 (-8.0, 4.4) -1.2 (-7.5, 5.1) -5.3 (-12.3, 1.7) 
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Combined 2020-

2021 (during 

pandemic)‡

compared with 

2016 (prepandemic year) 

0.0 (-6.2, 6.2) -4.6 (-10.8, 1.6) 0.6 (-6.2, 7.4) -2.3 (-8.4, 3.8) 

Combined 2020-

2021 (during 

pandemic)‡

compared with 

2015 (prepandemic year)

-3.9 (-10.4, 

2.6) 4.8 (-2.3, 11.9) 6.6 (0.2, 13.0)** 

* People in these reference birth years reached the given age in 2018 (pre-pandemic year) (e.g., for coverage by age 66 years, people 

born in 1952 reached 66 in 2018, which was before the pandemic). The pre-pandemic year (reference: yellow cell shading) is compared 

to pandemic years (2020 and 2021, blue cell shading; or 2020–2021, combined two blue cell shadings). † Age based on year of birth and survey year. For example, data for persons born in 1950 who reached age 65 were obtained from the 

2015 NHIS, and some could have still been age 64 when interviews were conducted.

‡ Combined 2020–2021 (during pandemic) by age, persons with the indicated birth year (rows) reached the age indicated (columns) in 

2020–2021 (combined two blue cell shadings) (e.g., for coverage by age 65 years, people born in 1955 or 1956 reached 65 in 2020 or

2021, which was during pandemic).

§ p<0.05 by t-test for comparisons within each age with the reference level (2018 estimate for each age) 

as indicated. 

** p<0.05 by t-test for comparisons within each age with the reference level (2019, 2017, 2016, 2015 estimates for each 

age) as indicated. 
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Table 3. Report of any prior pneumococcal vaccination (≥1 dose) by age and birth year 1948–1956, Behavioral Risk 

Factor Surveillance System 2015–2021*

By age 65† By age 66 By age 67 By age 68 By age 69 By age 70 

Combined age 

65-70 in 2018, 

2019 (prepandemic), 2020, 

and 2021 (during 

pandemic)‡

Birth year N

1948 37,960 62.3 (60.2, 64.3) 68.1 (66.2, 69.9) 73.9 (71.9, 75.8) 74.3 (72.4, 76.0) 64.3 (63.3, 65.2)

1949 44,648 61.5 (59.4, 63.5) 65.6 (63.4, 67.7) 72.2 (70.0, 74.2) 70.4 (68.1, 72.6) 73.0 (70.9, 74.9) 64.0 (63.1, 64.9)

1950 52,345 50.9 (48.9, 53.0) 60.3 (58.2, 62.3) 67.9 (65.6, 70.1) 68.0 (65.4, 70.5) 71.1 (68.5, 73.5) 68.8 (65.9, 71.5) 60.7 (59.6, 61.9)

1951 52,626 49.2 (47.3, 51.2) 63.6 (61.3, 65.9) 66.4 (64.3, 68.5) 68.9 (66.9, 70.9) 66.8 (63.5, 69.9) 69.9 (67.2, 72.5) 61.4 (60.3, 62.4)

1952 42,472 52.9 (50.7, 55.0) 58.4 (56.1, 60.6) 66.2 (64.0, 68.4) 65.7 (63.1, 68.3) 70.9 (68.7, 73.0)

1953 33,735 50.2 (48.0, 52.4) 59.6 (57.4, 61.7) 59.4 (56.6, 62.2) 68.3 (66.1, 70.5)

1954 24,789 47.5 (45.3, 49.7) 60.2 (57.4, 62.9) 61.9 (59.3, 64.5)

1955 16,611 46.2 (43.4, 49.0) 56.3 (53.6, 59.0)

1956 9,118 44.7 (42.4, 47.0)

Combined 

2020–2021 

(during 

pandemic) by 

age§

45.5 (43.7, 47.3) 58.3 (56.3, 60.2) 60.7 (58.7, 62.6) 67.0 (65.3, 68.7) 68.8 (66.8, 70.7) 69.3 (67.4, 71.2) 61.0 (60.3, 61.8)

*Table cells are shaded according to whether persons with the indicated birth year (rows) reached the age indicated (columns) in 2015–2017 and 

2019 or 2018 (pre-pandemic, shaded in orange or yellow) or in 2020 or 2021 (during pandemic, shaded in blue). Cells shaded in yellow were used 

as the pre-pandemic referent cell for comparisons with pandemic cells, for each age indicated (column).

† Age based on year of birth and survey year. For example, data for persons born in 1950 who reached age 65 were obtained from the 2015 BRFSS, 

and some could have still been age 64 when interviews were conducted.

‡ Combined age 65–70 in 2018 or 2019 (pre-pandemic, shaded in yellow or orange; n=54,257 for 2018 and n=49,526 for 2019) and 2020 or 2021 

(during pandemic, shaded in blue; n=46,123 for 2020 and n=50,552 for 2021).

§ Combined 2020–2021 (during pandemic) by age, persons with the indicated birth year (rows) reached the age indicated (columns) in 2020–2021 

(combined two blue cell shadings) (e.g., for coverage by age 65 years, people born in 1955 or 1956 reached 65 in 2020 or 2021, which was during 

pandemic).
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Table 4. Difference in uptake of pneumococcal vaccination (≥1 dose) by age and birth year 1948–1956, Behavioral Risk Factor 

Surveillance System 2015–2021*

By age 65† By age 66 By age 67 By age 68 By age 69 By age 70 

Combined age 

65–70 years in 

2018 (prepandemic), 2020, 

and 2021 (during 

pandemic)

Birth year N

1948 37960 ref ref

1949 44648 ref

1950 52345 ref -5.5 (-8.8, -2.2)‡ -3.6 (-5.1, -2.1)‡

1951 52626 ref -3.6 (-7.5, 0.3) -4.4 (-7.6, -1.2)‡ -2.9 (-4.3, -1.5)‡

1952 42472 ref -2.3 (-5.9, 1.3) 0.5 (-2.6, 3.6)

1953 33735 ref -7.0 (-10.5, -3.5)‡ 0.3 (-3.1, 3.7)

1954 24789 1.8 (-1.8, 5.4) -4.5 (-7.8, -1.2)‡

1955 16611 -4.0 (-7.6, -0.4)‡ -2.1 (-5.6, 1.4)

1956 9118 -5.5 (-8.7, -2.3)‡

Combined 2020–

2021 (during 

pandemic)§

compared with 

2019 (prepandemic)

-2.0 (-4.8, 0.8) -1.3 (-4.2, 1.6) -5.5 (-8.4, -2.6)** -1.9 (-4.5, 0.7) -2.3 (-5.5, 0.9) -3.7 (-6.5, -0.9)** -3.0, (-4.2, -1.8)**

Combined 2020–

2021 (during 

pandemic)§

compared with 

2018 (prepandemic)

-4.7 (-7.5, -1.9)‡ -0.1 (-3.1, 2.9) -5.7 (-8.6, -2.8)‡ -1.0 (-4.1, 2.1) -1.6 (-4.6, 1.4) -5.0 (-7.6, -2.4)‡ -3.3 (-4.5, -2.1)‡

Combined 2020–

2021 (during 

pandemic)§

compared with 

2017 (prepandemic)

-7.4 (-10.2, -4.6)** -5.3 (-8.3, -2.3)** -7.2 (-10.2, -4.2)** -5.2 (-7.9, -2.5)** -5.1 (-7.9, -2.3)** 

Combined 2020–

2021 (during 

pandemic)§

compared with 

2016 (prepandemic)

-3.7 (-6.4, -1.0)** -2.0 (-4.8, 0.8) -4.9 (-7.8, -2.0)** -1.1 (-3.6, 1.4) 
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Combined 2020–

2021 (during 

pandemic)§

compared with 

2015 (prepandemic)

-5.4 (-8.1, -2.7)** -3.2 (-6.0, -0.4)** -1.6 (-4.4, 1.2) 

*People in these reference birth years reached the given age in 2018 (pre-pandemic year) (e.g., for coverage by age 66 years, people born in 1952 

reached 66 in 2018, which was before the pandemic). The pre-pandemic year (reference: yellow cell shading) is compared to pandemic years (2020 and 

2021, blue cell shading; or 2020–2021, combined two blue cell shadings).

† Age based on year of birth and survey year. For example, data for persons born in 1950 who reached age 65 were obtained from the 2015 BRFSS, and 

some could have still been age 64 when interviews were conducted.

‡ p<0.05 by t-test for comparisons within each age with the reference level (2018 estimate for each age) as indicated. 

§ Combined 2020–2021 (during pandemic) by age, persons with the indicated birth year (rows) reached the age indicated (columns) in 2020–2021 

(combined two blue cell shadings) (e.g., for coverage by age 65 years, people born in 1955 or 1956 reached 65 in 2020 or 2021, which was during 

pandemic).

** p<0.05 by t-test for comparisons within each age with the reference level (2019, 2017, 2016, 2015 estimates for each age) as indicated.